Metrics of efficient use of operating rooms during the SARS-CoV-2 (COVID-19) pandemic

Introduction: the COVID-19 pandemic has induced a transformation in the way hospitals function, causing a decrease in the time and efforts dedicated to surgical activity, which in turn has caused delays in the surgery schedule of most hospitals. This represents a major public health problem, significantly compromising the principle of equity that inspires public health systems throughout the world. To address this problem, it would be of the utmost importance to put in place initiatives to measure and improve surgical efficiency. Objective: evaluate indicators of efficiency in the use of operating rooms during the COVID-19 pandemic. Material and methods: a descriptive, longitudinal retrospective study was conducted on 3554 patients scheduled for surgery during a one-year period of the COVID-19 pandemic. Indicators of efficiency in they use of operating rooms were measured. The data was processed using SPSS v-25.0. Results: a total of 3,554 surgeries were scheduled, 1,309 of them emergency surgeries, 1,979 elective surgeries, and 266 deferred surgeries. The following parameters were estimated: Starting time of the procedure (42.32 ± 37.04 min);opportunity for emergency surgeries (104.69 ± 102.55 min);starting time of anesthesia (10.11 ± 9.85 min);starting time of surgery (40.03 ± 24.68 min);time of admission to post-anesthesia care unit/intensive care unit (PACU/ICU) (15.35 ± 29.94 min);turnover or replacement time (177.97 ± 174.33 min);active surgery time (27.70%). Conclusions: the COVID-19 pandemic negatively impacted the indicators of efficient use of operating rooms, posing new challenges for the management and organization of surgical work. (English) [ FROM AUTHOR] Introducción: la pandemia por COVID-19 ha emplazado una transformación hospitalaria, esto acarreó un decremento de la actividad quirúrgica e implicó un aplazamiento en la programación, lo que representó un problema, ya que comprometió sensiblemente el principio de equidad que inspira a los sistemas sanitarios. Así, resultó imperativa la implementación de iniciativas para medir y mejorar la eficiencia quirúrgica. Objetivo: medir los indicadores de uso eficiente del quirófano durante la pandemia por COVID-19. Material y métodos: se realizó un análisis descriptivo, longitudinal y retrospectivo en 3,554 pacientes programados para cirugía, durante la pandemia en un período de un año, además se midieron los indicadores de uso eficiente del quirófano. Los datos fueron procesados en SPSS v-25.0. Resultados: se programaron 3,554 cirugías, 1,309 urgencias, 1,979 electivas, 266 diferidas. Se estimó un tiempo de inicio del procedimiento 42.32 ± 37.04 min, oportunidad para urgencias quirúrgicas 104.69 ± 102.55 min, tiempo de inicio de anestesia 10.11 ± 9.85 min, tiempo de inicio de cirugía 40.03 ± 24.68 min, tiempo para la admisión en la unidad de cuidados postanestésicos/unidad de terapia intensiva (UCPA/UTI) 15.35 ± 29.94 min, tiempo de rotación o recambio 177.97 ± 174.33 min y tiempo quirúrgico activo 27.70%. Conclusiones: la pandemia por COVID-19 impactó negativamente en los indicadores de uso eficiente del quirófano, lo que implicará nuevos retos en la gestión y organización de la jornada quirúrgica para su mejora. (Spanish) [ FROM AUTHOR] Copyright of Revista Mexicana de Anestesiologia is the property of Colegio Mexicano de Anestesiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The Potential of Work From Home for Determining Job Quality

Job quality is carefully studied in the research literature and there are multiple models for analyzing relevant indicators. The COVID-19 pandemic has impacted employees' work and lives, leading to changes in work patterns. Much of the discussions fell under the label of the possibility of working from different places and the implications of information technology on the perceived quality of a workplace. The present study examines the relationship between the perceived quality in the context of distance working. To address the current situation the study emphasizes how the theory, research, and practice have evolved in regard to perceived work quality and its implication for employees. The notion of perceived organization quality was broadened, and the implication of working from home was analyzed from the employees' point of view. How the possibility of working from home affects the perceived quality of an organization and how this will shape the organization's functions are subjects of this article. The findings contribute to the understanding of employees' behavior with choosing a workplace and the key factors that shape the image of a quality organization.

Values, indicators and policies. A reflection starting from sustainability issues and the Covid-19 pandemic

The article critically discusses the role of indicators, with particular reference to sustainability issues and the Covid-19 pandemic. The distinction between "cognitive values” and "ethical values” is assumed as fundamental in discussing the relationship between indicators and public policies.L'articolo discute criticamente il ruolo degli indicatori, con particolare riferimento ai temi della sostenibilità e della pandemia da Covid-19. La distinzione tra "valori epistemici” e "valori etici” è assunta come fondamentale nel discutere il rapporto tra indicatori e politiche pubbliche.

Achieving Zero Stunting: A Sustainable Development Goal Interlinkage Approach at District Level

The sustainable development goals (SDGs) provide an integrated framework of targets and indicators, including the elimination of stunting, to support better development planning. Indonesia faces a significant challenge as it ranks fourth globally in terms of stunting prevalence, exacerbated by disparities across regions, gender, and socioeconomic status, further compounded by the ongoing COVID-19 pandemic. Given the interlinked nature of SDGs, this study provides empirical support for the prioritization of SDG indicators, primarily in the context of stunting elimination at the district level in Indonesia. This study employed a combination of economic complexity and network theory, utilizing data from a comprehensive set of 54 indicators spanning 28 targets within 13 SDG goals in 514 districts. The analysis is based on network metrics, including revealed comparative advantage (RCA), proximity, centrality, and density to establish the SDG interlinkage network and identify key priority indicators. The findings highlight the importance of prioritizing indicators such as civil registration, health facilities and services, access to basic facilities and housing, and access to ICT in efforts to reduce stunting, particularly among disadvantaged households. Given the unique resources and capacities of each region, our analysis offers district-specific prioritization strategies for stunting elimination.

Socioemotional functioning as a moderator of the predictive ability of the DIAL-4 on academic achievement

Student performance on kindergarten screening measures and level of kindergarten-entry skills have been shown to be predictive of subsequent academic achievement, thus making kindergarten screening measures a useful tool that guides the monitoring of student progress over time. Though a commonly used tool to assist in kindergarten placement considerations by educators nationwide, the literature is lacking in studies that demonstrate the predictive ability of the Developmental Indicators for the Assessment of Learning - Fourth Edition (DIAL-4) on later academic achievement. Related, behavioral and emotional functioning has been demonstrated to significantly impact student achievement. While the literature supports the predictive ability of kindergarten screening measures on academic performance, research is limited on how behavioral functioning moderates this predictive relationship. The present study aimed to examine the predictive ability of the DIAL-4 on later academic achievement and identify whether behavioral and emotional functioning impacts upon, and to what degree, the relationship between academic achievement and the DIAL-4. Additionally, this study examined the impact of the pause of in-person learning, as caused by the COVID-19 pandemic on student achievement and behavioral and emotional functioning through within-samples comparisons of student functioning in 2019 and 2021 to identify change amongst individual students. The results support the predictive ability of the DIAL-4 on subsequent academic achievement with significant correlations between DIAL-4 scores obtained before kindergarten with subsequent measures of academic achievement. The was no evidence found for a moderation effect of behavioral and emotional functioning on the prediction of academic achievement. Lastly, when controlling for scores on the DIAL-4, the data suggest a decrease in rate of student academic achievement and an increase in emotional and behavioral dysregulation following the onset of the COVID-19 pandemic demonstrated by statistically significant differences in BERI scores as well as significant decreases in rates of growth in reading ability within some cohorts. These findings provide educators with empirical evidence for the utility of the DIAL-4 in predicting academic achievement as well as insight into how the COVID-19 pandemic impacted students' functioning. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Biodiversity, Urban Quality Life and Air Quality Indices for Hotspot Detection of Transformation Opportunities in Cities: A Case Study in Barcelona

Half of the world's population lives in cities, where usually there are few little green space and there are also high levels of air pollution. Moreover, the traditional urbanization of cities contributes to climate change, promotes the loss of global biodiversity and induces serious health problems for citizens. Both climate change and the loss of biodiversity affect negatively to the ecosystems and therefore human health, as they are responsible for providing clean air, food, fresh water, medicines, renewable resources. . . This deterioration increases significantly the risk of human-borne infectious diseases such as coronavirus or HIV. The ability we have to re-naturalize anthropogenic spaces and learn to generate spaces for coexistence will be key for the future of our society. The research presented in this paper aims to do a step forward to achieve that ability by working in three schools of the city of Barcelona and their surroundings. Among other actions, in this project, a diagnosis of neighborhood has been carried out. The diagnosis includes the identification and quantification of relevant indicators regarding neighborhood's biodiversity and also the quality of daily life and the analysis of pollutants (NO2 and PM10) near the schools during the 2021-2022 school year. All these information has been merged in a single geographic data base and relevant hotspots where to act have been identified. The information has been shared with city council and citizens. Copyright © 2023 by SCITEPRESS – Science and Technology Publications, Lda.

Monitoring the Construction Sector in Valle del Cauca

The objective of this research is to develop a monthly indicator that synthesizes the economic acti-vity of the construction sector in Valle del Cauca, as a tool for analyzing the production cycle and as a single, public measure that contributes to decision-making. Dynamic factorial models, the Kalman filter and the Litterman method are used, also employed in the Monthly Index of Economic Activity (IMAE), in order to capture signals, changes in the productive cycle of construction and compile the sectoral economic facts that affect production. In the results, the dynamics of the sectoral and economic variables are observed that explain the behavior of the sector in Valle del Cauca during 2009-2020. A change of slope is observed in 2020, as a direct consequence of the crisis generated by COVID-19 and the restrictive measures taken by the government to contain its advance.

A Hybridized Stochastic SIR-Vasicek Model in Evaluating a Pandemic Emergency Financing Facility

In the context of the present global health crisis, we examine the design and valuation of a pandemic emergency financing facility (PEFF) akin to a catastrophe (CAT) bond. While a CAT bond typically enables fund generation to the insurers and re-insurers after a disaster happens, a PEFF or pandemic bond's payout is linked to random thresholds that keep evolving as the pandemic continues to unfold. The subtle difference in the timing and structure of the funding payout between the usual CAT bond and PEFF complicates the valuation of the latter. We address this complication, and our analysis identifies certain aspects in the PEFF's design that must be simplified and strengthened so that this financial instrument is able to serve the intent of its original creation. An extension of the compartmentalized deterministic epidemic model-which describes the random number of people in three classes: susceptible (S), infected (I), and removed (R) or SIR for short-to its stochastic analog is put forward. At time t, S(t), I(t), and R (t) satisfy a system of interacting stochastic differential equations in our extended framework. The payout is triggered when the number of infected people exceeds a predetermined threshold. A CAT-bond pricing setup is developed with the Vasicek-based financial risk factor correlated with the SIR dynamics for the PEFF valuation. The probability of a pandemic occurrence during the bond's term to maturity is calculated via a Poisson process. Our sensitivity analyses reveal that the SIR's disease transmission and recovery rates, as well as the interest rate's mean-reverting level, have a substantial effect on the bond price. Our proposed synthesized model was tested and validated using a Canadian COVID-19 dataset during the early development of the pandemic. We illustrate that the PEFF's payout could occur as early as seven weeks after the official declaration of the pandemic, and the deficiencies of the most recent PEFF sold by an international financial institution could be readily rectified.

Evolution of oilseed sector in Romania - an analysis from the perspective of effects produced by the COVID-19 pandemic

Romania ranks first in the European Union for the production of sunflower seeds, third for the production of soybeans and seventh for the production of rapeseed. The paper aims to analyse the effects produced by the COVID-19 pandemic on the evolution of the oilseed sector in Romania. Thus, the following indicators were analysed: evolution of areas under oilseeds, total oilseed production and average yields, as well as the volatility of selling prices for oilseeds. The results of the study reveal that Romania has been the largest producer of sunflower seeds in the European Union. The average yields in sunflower, soybeans and rapeseed have shown great variations in the analysed period. According to Eurostat data, it can be noticed that although Romania is the third large producer of oilseeds in the EU, the average yields continue to be low compared to those from other large EU producers. Yields are also among the most volatile in the EU. The selling prices for soybeans showed a higher increase in the year 2020 than in 2019 in Romania, compared to the increase in the average selling prices of the EU-27 (+9.89%). The selling prices for rapeseed also had a higher increase in 2020 than in 2019 in Romania, compared to the increase in the average selling prices of the EU-27 (+2.31%).

REVIEW AND ANALYSIS OF EXISTING METHODS TO ASSESS THE INDOOR ENVIRONMENTAL QUALITY (IEQ) FOR OFFICE BUILDINGS

Population in developed countries spend most of their time indoors, whether in their homes, workplaces, stores or leisure areas. Due to the COVID-19 pandemic, this situation worsened and now, more than ever, the importance of a high Indoor Environmental Quality (IEQ) is highlighted. The IEQ is very important in building performance since it is directly related to its occupants' comfort, health, wellbeing, and productivity and the Sick Building Syndrome (SBS) concept. Therefore, it is essential to develop tools to support designers' decision-making in the materialization of indoor environments with higher quality. From the state-of-art analysis, it is possible to conclude that the methods to assess the overall building performance already consider the IEQ. Still, most use an approach that does not cover all relevant indicators. In this context, this paper presents the first milestone of a research work that aims to develop a new method to rate the overall IEQ of office buildings in Portugal. The main objective of the present study is to propose a list of IEQ indicators for office buildings, adapted to the Portuguese context, based on the analysis of existing rating methods for buildings and the recommendations of national and international standards. © 2022 The Author(s). Licensed under a CC-BY 4.0 licence.

Measuring opportunities: Transforming Indonesia's economy through utilizing natural resources for sustainable development through green economy indicators

Many countries with low to medium incomes need a long time to recover from the economic downturn caused by Covid-19. The impact of Covid-19 affects the main development priorities in Indonesia, such as poverty alleviation, the achievement of sustainable development, and the transformation of the green economy. The economic and fiscal constraints facing Indonesia need attention, and the Indonesian economy needs to establish policy criteria. The purpose of this article is to analyze the environmental problems in Indonesia and then identify the government policy related to sustainable development programs to release them. The Ministry of Finance has an essential role in the SDGs by allocating National Budget to environmental programs. Sustainable development is Indonesia's commitment to the international community to reduce the use of carbon emissions to promote a green economy. The green economy indicators that we elaborate in supporting SDGs programs are low-carbon development, resource efficiency, and socially inclusive.

Diagnóstico situacional de seguridad alimentaria en Argentina, Brazil, Colombia e Inglaterra post Covid-19

O artigo analisa as iniciativas de promoção da segurança alimentar na Argentina, Brasil, Colômbia e Inglaterra a partir do desenho de um diagnóstico situacional dos países em questão, no período pós-Covid-19. São dados secundários recentes de agências de pesquisa locais e multilaterais que questionam a gama de indicadores de riqueza e pobreza versus insegurança alimentar entre a população mais vulnerável. Avança também no modo de produzir alimentos em larga escala, principalmente a economia baseada em commodities, questionando a soberania na produção de alimentos e a contradição com as premissas do desenvolvimento sustentável. Busca evidenciar a implementação de alguns programas e políticas sociais. Nesses países, para cuidar de famílias em situação de vulnerabilidade social.Alternate :El artículo analiza iniciativas para promover la seguridad alimentaria en Argentina, Brazil, Colombia e Inglaterra a partir del diseño de un diagnóstico situacional de los países en mención, en el periodo post-Covid-19. Se trata de datos secundarios recientes de agencias de investigación locales y multilaterales que cuestionan la gama de indicadores de riqueza y pobreza frente a la inseguridad alimentaria entre la población más vulnerable. También avanza sobre la forma de producir alimentos a gran escala, en especial la economía basada en commodities, cuestionando la soberanía en la producción de alimentos y la contradicción frente a las premisas para el desarrollo sostenible. Busca evidenciar sobre la implementación de algunos programas y políticas sociales. En los referidos países, para atender a las familias en situación de vulnerabilidad social.Alternate :The article analyzes the initiatives to promote food security in Argentina, Brazil, Colombia and England based on the design of a situational diagnosis of the countries in question, in the post-Covid-19 period. These are recent secondary data from local and multilateral research agencies that question the range of indicators of wealth and poverty versus food insecurity among the most vulnerable population. It also advances in the way of producing food on a large scale, mainly the economy based on commodities, questioning the sovereignty in food production and the contradiction with the premises of sustainable development. It seeks to highlight the implementation of some social programs and policies. In these countries, to care for families in situations of social vulnerability.

Enhancing compliance rate of hand hygiene before and after Covid-19: An interference analysis in Abu Dhabi, UAE hospitals

Hand hygiene (HH) is a crucial factor for reducing Healthcare Associated Infections (HAIs) in the hospital setting. The current analysis was created to create an intervention methodology to enhance hand hygiene compliance among hospital personnel in a healthcare setting. Covid-19 disease epidemic has additional stressed the need for world-wide development in hand hygiene compliance by the healthcare personnel. Healthcare Associated Infections have been a hot issue for several time periods and Healthcare Associated Infections are the most common adverse results due to the delivery of medical care and treatment. There is unanimity that hand hygiene is the extremely successful way to avoid healthcare associated infections. As healthcare systems fluctuate widely, prevention approaches must be designed appropriately. Hand hygiene, however, remains relevant in all settings, and World Health Organization (WHO) is strongly endorsing alcohol-based hand rubs to interrupt transmission. Nevertheless, very minimal compliance rate amongst the healthcare staff have been reported worldwide. Infected surfaces, especially those that are touched repeatedly by the patient's surroundings, act as reservoirs for pathogens and cause towards pathogen transmission. Therefore, healthcare disinfection requires a thorough approach whereby several strategies may be applied together, risk-based methodologies, to decrease the possibility of HAIs for the patients. In this paper more than 200 articles have been studied from 2016 to 2021 time period and various surveys have been conducted to analyze hand hygiene intervention and studied the various factors involving the patient's situation, medication management behavior of several units, and the type of healthcare employees during and before the Covid-19 pandemic. Based on this study, we evaluated overall hand hygiene compliance rate including the intake of hand wash liquid agent, alcohol-based hand rub (ABHR), the paper wipes, medical waste consumption and personal protective equipment's (gloves, masks etc.) before and after Covid-19 intervention to improve the hand hygiene compliance rate in Abu Dhabi hospitals. © 2023 Author(s).

A Survey on Handover and Mobility Management in 5G HetNets: Current State, Challenges, and Future Directions.

Fifth-generation (5G) networks offer high-speed data transmission with low latency, increased base station volume, improved quality of service (QoS), and massive multiple-input-multiple-output (M-MIMO) channels compared to 4G long-term evolution (LTE) networks. However, the COVID-19 pandemic has disrupted the achievement of mobility and handover (HO) in 5G networks due to significant changes in intelligent devices and high-definition (HD) multimedia applications. Consequently, the current cellular network faces challenges in propagating high-capacity data with improved speed, QoS, latency, and efficient HO and mobility management. This comprehensive survey paper specifically focuses on HO and mobility management issues within 5G heterogeneous networks (HetNets). The paper thoroughly examines the existing literature and investigates key performance indicators (KPIs) and solutions for HO and mobility-related challenges while considering applied standards. Additionally, it evaluates the performance of current models in addressing HO and mobility management issues, taking into account factors such as energy efficiency, reliability, latency, and scalability. Finally, this paper identifies significant challenges associated with HO and mobility management in existing research models and provides detailed evaluations of their solutions along with recommendations for future research.

An assessment of the relationship between national rates of Covid-19 incidence and mortality as reported to an international comparison database: An ecological study.

Background and Aims: Making a judgment only based on formal national reports can be misleading. We aimed to assess the relationship between countries' development indicators and reported coronavirus disease 2019 (Covid-19)-related incidences and death. Methods: Covid-19 related incidence and death cases were extracted from the updated Humanitarian Data Exchange Website on October 8, 2021. Univariable and multivariable negative binomial regression were utilized to investigate the relationship between development indicator and incidence and mortality from Covid-19 by calculating the Incidence rate ratio (IRR), mortality rate ratio (MRR), and fatality risk ratio (FRR). Results: Very high human development index (HDI) compared with low HDI (IRR:3.56; MRR:9.04), the proportion of physicians (IRR:1.20; MRR:1.16), besides extreme poverty (IRR:1.01; MRR:1.01) were independently correlated with the mortality and incidence rate of Covid-19. Very high HDI and population density were inversely correlated with the fatality risk (FRRs of 0.54 and 0.99). The cross-continental comparison shows Europe and the North Americas, had significantly higher incidence and mortality rates with IRR of 3.56 and 1.84 as well as MRRs of 6.65 and 3.62, respectively. Also, they inversely correlated with the fatality (FRR:0.84 and 0.91, respectively). Conclusion: A positive correlation between the fatality rate ratio based on countries' development indicators and the reverse for the incidence and mortality rate was found. Developed countries with sensitive healthcare systems can diagnose infected cases as soon as possible. Also, the mortality rate of Covid-19 will be accurately registered and reported. Due to more access to diagnostic tests, patients are diagnosed at the initial stages and will have a better opportunity to receive treatment. This leads to higher reports of incidence/and/or mortality rates and lower fatality of COVID-19. In conclusion, more Covid-19 incidence and mortality cases in developed countries can result from a more comprehensive care system and a more accurate recording procedure.

Housing market forecasts via stock market indicators.

Through the reinterpretation of housing data as candlesticks, we extend Nature Scientific Reports article by Liang and Unwin [LU22] on stock market indicators for COVID-19 data, and utilize some of the most prominent technical indicators from the stock market to estimate future changes in the housing market, comparing the findings to those one would obtain from studying real estate ETF's. By providing an analysis of MACD, RSI, and Candlestick indicators (Bullish Engulfing, Bearish Engulfing, Hanging Man, and Hammer), we exhibit their statistical significance in making predictions for USA data sets (using Zillow Housing data) and also consider their applications within three different scenarios: a stable housing market, a volatile housing market, and a saturated market. In particular, we show that bearish indicators have a much higher statistical significance then bullish indicators, and we further illustrate how in less stable or more populated countries, bearish trends are only slightly more statistically present compared to bullish trends.

The impact of the COVID-19 pandemic on emergency care of acute myocardial infarction: findings from the Taiwan Clinical Performance Indicator.

Acute myocardial infarction (AMI) treatment requires timely diagnosis and treatment for optimal health outcomes. The Coronavirus Disease (COVID-19) pandemic has caused changes in health-care delivery and utilization; therefore, the present study explored the changes in emergency care quality indicators for patients with AMI before and during different periods of government response to the COVID-19 outbreak in Taiwan. The Taiwan Clinical Performance Indicators database was used to evaluate the impact of COVID-19 on acute care quality indicators for patients with AMI during four periods: before the COVID-19 outbreak (Period I-1 January to 31 December 2019) and during three periods in which the central government imposed different levels of epidemic prevention and response alerts (Period II-1 January 2020 to 30 April 2021; Period III-1 May to 31 July 2021; and Period IV-1 August to 31 December 2021). A 15.9% decrease in monthly emergency department admission for patients with AMI occurred during Period III. The hospital 'door-to-electrocardiogram time being <10 min' indicator attainment was significantly lower during Periods III and IV. The attainment of 'dual antiplatelet therapy received within 6 hr of emergency department arrival' indicator improved in Period IV, whereas 'the primary percutaneous coronary intervention being received within 90 min of hospital arrival' indicator significantly decreased during Periods III and IV. The indicator 'in-hospital mortality' was unchanged within the study duration. Overall, the quality of care for patients with AMI was mildly influenced during the assessed pandemic periods, especially in terms of door-to-electrocardiogram time of <10 min and primary percutaneous coronary intervention received within 90 min of hospital arrival (Period III). Using our study results, hospitals can develop strategies regarding care delivery for patients with AMI during a COVID-19 outbreak on the basis of central government alert levels, even during the height of the pandemic.

Surveillance of RNase P, PMMoV, and CrAssphage in wastewater as indicators of human fecal concentration across urban sewer neighborhoods, Kentucky.

Wastewater surveillance has been widely used as a supplemental method to track the community infection levels of severe acute respiratory syndrome coronavirus 2. A gap exists in standardized reporting for fecal indicator concentrations, which can be used to calibrate the primary outcome concentrations from wastewater monitoring for use in epidemiological models. To address this, measurements of fecal indicator concentration among wastewater samples collected from sewers and treatment centers in four counties of Kentucky (N = 650) were examined. Results from the untransformed wastewater data over 4 months of sampling indicated that the fecal indicator concentration of human ribonuclease P (RNase P) ranged from 5.1 × 101 to 1.15 × 106 copies/ml, pepper mild mottle virus (PMMoV) ranged from 7.23 × 103 to 3.53 × 107 copies/ml, and cross-assembly phage (CrAssphage) ranged from 9.69 × 103 to 1.85 × 108 copies/ml. The results showed both regional and temporal variability. If fecal indicators are used as normalization factors, knowing the daily sewer system flow of the sample location may matter more than rainfall. RNase P, while it may be suitable as an internal amplification and sample adequacy control, has less utility than PMMoV and CrAssphage as a fecal indicator in wastewater samples when working at different sizes of catchment area. The choice of fecal indicator will impact the results of surveillance studies using this indicator to represent fecal load. Our results contribute broadly to an applicable standard normalization factor and assist in interpreting wastewater data in epidemiological modeling and monitoring.

20-Month monitoring of SARS-CoV-2 in wastewater of Curitiba, in Southern Brazil.

The COVID-19 pandemic resulted in the collapse of healthcare systems and led to the development and application of several approaches of wastewater-based epidemiology to monitor infected populations. The main objective of this study was to carry out a SARS-CoV-2 wastewater based surveillance in Curitiba, Southern Brazil Sewage samples were collected weekly for 20 months at the entrance of five treatment plants representing the entire city and quantified by qPCR using the N1 marker. The viral loads were correlated with epidemiological data. The correlation by sampling points showed that the relationship between the viral loads and the number of reported cases was best described by a cross-correlation function, indicating a lag between 7 and 14 days amidst the variables, whereas the data for the entire city presented a higher correlation (0.84) with the number of positive tests at lag 0 (sampling day). The results also suggest that the Omicron VOC resulted in higher titers than the Delta VOC. Overall, our results showed that the approach used was robust as an early warning system, even with the use of different epidemiological indicators or changes in the virus variants in circulation. Therefore, it can contribute to public decision-makers and health interventions, especially in vulnerable and low-income regions with limited clinical testing capacity. Looking toward the future, this approach will contribute to a new look at environmental sanitation and should even induce an increase in sewage coverage rates in emerging countries.

Factors associated with exclusive breastfeeding in Israel during the COVID-19 pandemic: a subset of the IMAgiNE EURO cross-sectional study.

BACKGROUND: Evidence has shown that restrictions during the COVID-19 pandemic have negatively affected breastfeeding support and outcomes in hospitals in many countries. The aims of the study were to describe exclusive breastfeeding rates and identify factors associated with exclusive breastfeeding at hospital discharge among women who gave birth during the COVID-19 pandemic in Israel. METHODS: A cross-sectional online anonymous survey based on WHO standards for improving quality of maternal and newborn care in health facilities was conducted among a sample of women who gave birth to a healthy singleton infant in Israel during the pandemic (between March 2020 and April 2022). The socio-ecological approach was employed to examine intrapersonal, interpersonal, organizational, and community/society factors associated with exclusive breastfeeding at hospital discharge according to women perspectives. RESULTS: Among the 235 Israeli participants, 68.1% exclusively breastfed, 27.7% partially breastfed, and 4.2% did not breastfeed at discharge. Results of the adjusted logistic regression model showed that factors significantly associated with exclusive breastfeeding were the intrapersonal factor of multiparity (adjusted OR 2.09; 95% Confidence Interval 1.01,4.35) and the organizational factors of early breastfeeding in the first hour (aOR 2.17; 95% CI 1.06,4.45), and rooming-in (aOR 2.68; 95% CI 1.41,5.07). CONCLUSIONS: Facilitating early breastfeeding initiation and supporting rooming-in are critical to promoting exclusive breastfeeding. These factors, reflecting hospital policies and practices, along with parity, are significantly associated with breastfeeding outcomes and highlight the influential role of the maternity environment during the COVID-19 pandemic. Maternity care in hospitals should follow evidence-based breastfeeding recommendations also during the pandemic, promoting early exclusive breastfeeding and rooming-in among all women, with particular attention to providing lactation support to primiparous women. TRIAL REGISTRATION: Clinical Trials NCT04847336.